Electrophysiologic characteristics and radiofrequency catheter ablation in atrioventricular node reentrant tachycardia with second-degree atrioventricular block

Shih Huang Lee, Shih Ann Chen, Ching Tai Tai, Chern En Chiang, Zu Chi Wen, Kwo Chang Ueng, Chuen Wang Chiou, Yi Jen Chen, Wen Chung Yu, Jin Long Huang, Jun Jack Cheng, Mau Song Chang

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Abstract

Introduction: Detailed electrophysiologic study of AV nodal reentrant tachycardia (AVNRT) with 2:1 AV block has been limited. Methods and Results: Six hundred nine consecutive patients with AVNRT underwent electrophysiologic study and radiofrequency catheter ablation of the slow pathway. Twenty-six patients with 2:1 AV block during AVNRT were designated as group I, and those without this particular finding were designated as group II. The major findings of the present study were: (1) group I patients had better anterograde and retrograde AV nodal function, shorter tachycardia cycle length (during tachycardia with 1:1 conduction) (307 ± 30 vs 360 ± 58 msec, P <0.001), and higher incidence of transient bundle branch block during tachycardia (18/26 vs 43/609, P <0.001) than group II patients; (2) 21 (80.8%) group I patients had alternans of AA intervals during AVNRT with 2:1 AV block. Longer AH intervals (264 ± 26 vs 253 ± 27 msec, P = 0.031) were associated with the blocked beats. However, similar HA intervals (51 ± 12 vs 50 ± 12 msec, P = 0.363) and similar HV intervals (53 ± 11 vs 52 ± 12, P = 0.834) were found in the blocked and conducted beats; (3) ventricular extrastimulation before or during the His-bundle refractory period bundle could convert 2:1 AV block to 1:1 AV conduction. Conclusions: Fast reentrant circuit, rather than underlying impaired conduction of the distal AV node or infranodal area, might account for second-degree AV block during AVNRT. Slow pathway ablation is safe and effective in patients who have AVNRT with 2:1 AV block.

Original languageEnglish
Pages (from-to)502-511
Number of pages10
JournalJournal of Cardiovascular Electrophysiology
Volume8
Issue number5
Publication statusPublished - 1997
Externally publishedYes

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Keywords

  • atrioventricular block
  • atrioventricular nodal reentrant tachycardia
  • catheter ablation
  • electrophysiologic study
  • radiofrequency

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology

Cite this

Lee, S. H., Chen, S. A., Tai, C. T., Chiang, C. E., Wen, Z. C., Ueng, K. C., Chiou, C. W., Chen, Y. J., Yu, W. C., Huang, J. L., Cheng, J. J., & Chang, M. S. (1997). Electrophysiologic characteristics and radiofrequency catheter ablation in atrioventricular node reentrant tachycardia with second-degree atrioventricular block. Journal of Cardiovascular Electrophysiology, 8(5), 502-511.